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Revista chilena de pediatría

versión impresa ISSN 0370-4106


BAKIR, Julia et al. Epidemiological profile of invasive infections caused by Streptococcus pneumoniae. Rev. chil. pediatr. [online]. 2003, vol.74, n.1, pp.105-113. ISSN 0370-4106.

Introduction. Streptococcus pneumoniae (Sp) is a main cause of morbidity and mortality in children, and the increasing rates of drug resistant strains have been reported. The objectives of this study were to determine the epidemiology of invasive pneumococcal infections and the risk factors of Sp penicillin resistance (PR). Material & methods: Two hundred seventy four children with invasive pneumococcal infections hospitalized in a children hospital, in the 1993-1999 period; the median age was 21.5 months (1 month-18 years), the male to female ratio was 1.7:1. Fifty two percent of cases reported an underlying disease. Results: The most frequent diseases were: pneumonia 64.2%, meningitis 11.6%, sepsis/bacteriemia 10.9%, peritonitis 7.8%. Sp was recovered in 325 samples: blood in 55.1%, pleural fluid 27.1%, cerebrospinal fluid (CSF) 9.2%, peritoneal fluid 5.5% and other fluids obtained by puncture 3.1%. PR rate was 31,8% (87/274), 17.9% were highly resistant. Differences in the annual distribution was observed. 65.5% from PR strains were resistant to third generation cephalosporins too. PR was associated with: previous beta-lactam antibiotics therapy (RR 2.61; 1.91-3.55); nosocomial infection (RR 2.72; 2.00-3.69), pneumonia (RR 2.06; 1.32-3.22), and age under two years (RR 1.72; 1.18-2.49). Results from multivariate logistic regression analysis of binary predictors of PR were: previous beta-lactam antibiotics therapy (p = 0,0003), nosocomial infection (p = 0,0019) and pneumonia (p = 0,0445). Mortality was 6,2% (17/274) without correlation with PR. Conclusion: These findings suggest the need for a continuous surveillance, control of drug resistant pneumococci and vaccination with an effective vaccine among high-risk patients

Palabras clave : invasive infection; Streptococcus pneumoniae; antibiotic resistance; risk factors.

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